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General NPI Number Information
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NPI Number | 1881931012
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Entity Type | Individual
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Provider Name | ANA CHRISTINA MALACHOWSKI L.M.T, M.M.P,
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Gender | Female
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Dates
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Enumeration Date | 01/08/2013
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Last Update Date | 01/08/2013
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Provider Practice Location Address
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Address Line | 728 N MONTEZUMA ST STE A
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City | PRESCOTT
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State | AZ
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Zip | 86301-2090
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Country | US
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Telephone | 928-778-0147
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Fax | 928-778-0772
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Provider Business Mailing Address
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Address Line | 4742 N HARLEQUIN DR
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City | PRESCOTT VALLEY
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State | AZ
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Zip | 86314-3714
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Country | US
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Telephone | 928-308-2723
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Fax | 928-778-0772
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-15916
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License Number State | CA
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